LEWISTON, Maine — On an 11-degree night here this month, an unconventional mass was held outdoors, next to a 2017 Honda parked on a street corner.

The altar took the form of the small car’s hatchback trunk. The not-so-typical communion: sterile needles, the overdose antidote naloxone, and the rubber tourniquets used prior to drug injection. For shooting and mixing heroin hygienically, alcohol swabs and sterile water. For the cold, hand warmers and socks, and for the hungry, granola bars.

At the center of it all was Jesse Harvey, 26, a Portland-area peer recovery coach who is the founder of the Church of Safe Injection.

The congregation lends structure to a rogue coalition of harm-reduction advocates who work to distribute thousands of syringes — possessing more than 10 is illegal in Maine — as well as hundreds of doses of naloxone. Members of the “church” don’t take that title lightly.

The decision to brand the organization as a church could also provide a strange element of legal protection. If Harvey is arrested for his work — and he hopes he will be — he will argue that he was merely carrying out his own First Commandment: harm reduction.

The contents of a needle disposal bin in the back of Harvey’s car.

At a time when more than 70,000 Americans die each year from overdose and when infectious disease rates have spiked across the country, he will argue it is more criminal to follow a state law prohibiting the possession of more than 10 syringes than to disobey it. The church’s legally hazy efforts, Harvey said, are an attempt at the salvation public health officials across the country have failed to provide.

“The people who are flocking to the church are sincere in their desire to see people who use drugs live lives of purpose and not be lost to preventable death,” Harvey said. “It’s not a gimmick.”

In some cases, they have already run up against law enforcement. Maine’s Center for Disease Control and Prevention last month requested that Lewiston Police prevent Harvey from continuing his work there. Harvey, individually, has complied with their request to stop distributing clean syringes. Other church members have continued, and even accelerated, their distribution tactics.

In the last three months, Harvey’s church has fanned out in six chapters across Maine and in six other states — down the Eastern Seaboard and as far as Tennessee — to spread the gospel of harm reduction.

One day, Harvey hopes the church will facilitate a harm-reduction practice still illegal across the United States: supervised injection, in which health workers provide a controlled space for drug use, aiming to decrease overdoses and ensure health professionals are onsite if an overdose occurs.

The church respects law enforcement and will work with them where possible, Harvey said. But, as Harvey wrote last month: “The Church of Safe Injection is compelled to break the law because of our commitment to humanity, human rights, and public health.”

A Universal Life Church Ministries decal is seen through the windshield of Harvey’s car.

In 2006, the Supreme Court ruled that a New Mexico sect of a Brazilian spiritualist society could continue drinking tea spiked with ayahuasca, a powerful and highly illegal hallucinogen, to fulfill a religious obligation. In 1994, Congress also tweaked the same law the New Mexico church cited to ensure some Native American tribes could continue using a similarly illegal hallucinogen, peyote, in ritual practice.

Harvey cites the ayahuasca precedent often, heartened that there could be a legal basis for sanctioning otherwise illegal activities in the name of the church.

He has not filed paperwork to formally incorporate as a religious organization, though he plans to. He also has not yet applied to become a certified syringe-exchange program.

Another potential snag in Harvey’s religious quest: those who have come before him with seemingly less sincerity. Last year a federal court ruled against a man who said he was a “student of Esoteric and Mysticism studies,” and fulfilling a religious mandate in his effort to defend against a charge for possession of heroin with intent to distribute.

Harvey hopes his church appears more sincere, and he knows what his ideal law enforcement run-in looks like — an arrest not for distributing needles for intravenous drug use, but the needles used for injecting naloxone directly into deep-muscle tissue.

“Giving naloxone and bringing people back to life is as much of a miracle as I’ve ever seen. If that’s not reason enough to call it a church, I can’t think of one.”

Jess Tilley, founder of the New England Drug Users Union

“I want to specifically get arrested for intramuscular syringes to prove the absurdity of the law,” he said. “To prove I’m getting arrested for distributing lifesaving medications.”

To brand as a “church,” however, is an interesting choice, as several addiction medicine experts pointed out to STAT. Some of the country’s faith community has been unwilling to support evidence-based addiction treatments for congregants who seek help.

“At 23, I go into a Baptist church, fully addicted to heroin,” said Jess Tilley, the founder of the New England Drug Users Union, a coalition that advocates for better treatment of people who use drugs. “They laid hands on me and thought they would cure me.”

Harvey has found other ways to tout his newfound religious credentials, too. As of November, he is a minister ordained by the aptly named Universal Life Church, the interfaith organization known for ordaining those wishing to perform ritual ceremonies like weddings and funerals.

During his mobile exchanges, Harvey displays a parking pass that came with his ordination in his car window, proclaiming he is on “ministerial business.”

“Giving naloxone and bringing people back to life is as much of a miracle as I’ve ever seen,” Tilley said. “If that’s not reason enough to call it a church, I can’t think of one.”

A sign advertising free Narcan, a version of naloxone, rests on the side of Harvey’s car in a parking lot.

Harvey displays a spreadsheet that uses de-identified data to keep track of clients who use his services.

Maine’s lukewarm response to harm reduction — and to Harvey’s rebellion, specifically — comes at a time when harm-reduction practices are becoming more widely accepted across North America.

In Vancouver, Canada, vending machines dispense highly regulated prescription opioids to drug users who public health workers fear would otherwise use black-market heroin. In California, lawmakers are optimistic that Gavin Newsom, the incoming governor, will sign a bill vetoed by a prior administration that would authorize a pilot supervised injection program, which would violate federal law

But Lt. David St. Pierre, the public affairs officer for the Lewiston police, isn’t budging, on the basis that Harvey has not applied to become a sanctioned provider of syringe exchange. (Harvey said his organization would have a “snowball’s chance in hell” of being approved.)

“In this case involving Jesse Harvey, we have contacted Maine CDC and have learned that Mr. Harvey is NOT a part of the needle exchange programs; therefore he would be in violation of the law,” he told STAT in a statement, adding that Harvey has been cooperative to date.

Emily Spencer, a spokeswoman for Maine’s CDC, provided a list of technical guidance for local syringe exchange programs in response to STAT’s questions, and reiterated that Harvey was not licensed to practice syringe exchange. The Maine CDC also sent a similar guidance to a number of local syringe exchanges on Nov. 27, seemingly to highlight the illegality underpinning the Church of Safe Injection.

While it is a crime in Maine to possess or distribute more than 10 syringes, Harvey said the Church of Safe Injection currently holds a stock of over 6,000. Harvey is hesitant to reveal the source of the church’s supplies, saying that some are paid for by members and others were funded by a recent supplies grant worth $1,000 from the North American Syringe Exchange Network. Others still come from “anonymous donors,” he said.

Harvey drives through Lewiston to meet with volunteers at a nearby parking lot.

This week, Lewiston’s Church of Safe Injection will take the latest in a series of steps to expand. For the first time, it will meet in the house of one of its members, giving brick-and-mortar credibility to an operation previously run out of Harvey’s trunk. The house provides a logical opportunity for Harvey to someday pursue the long-term goal of supervised injection.

There are just six certified syringe exchanges in Maine, a state that spans nearly 400 miles from between New Hampshire and Canada. Just four distribute naloxone. Just three run five days per week.

The Trump administration remains staunchly opposed to supervised injection, and even efforts to promote syringe exchange from the highest levels of government have proven a struggle. Vice President Mike Pence, as governor of Indiana, famously needed the urging of his top health adviser before allowing syringe exchange in a community ravaged by HIV.

While Harvey has made good on a personal pledge to refrain from distributing needles, other church members have ignored the police directive. One, who requested to be identified by the name Morgan, said she still gives out clean syringes in exchange for used ones at an even ratio. Her operation has helped the Lewiston chapter replace over 1,200 used syringes with new ones and distribute nearly 100 naloxone doses.

(STAT agreed not to fully identify several members of the Church of Safe Injection referred to in this story. Many requested anonymity because of the stigma injection drug use carries in America and because many of the activities they describe are illegal.)

Other chapters, however are finding success unencumbered by local law enforcement. A chapter in Bangor, a city of 33,000 a two-hour’s drive further northeast, is nonetheless vigilant, and designates members to keep watch to guard against patrolling police. In other cities and states, the movements are so fledgling they have either gone undetected or ignored by authorities.

“At this point, we need to be pulling out all the stops, and mobile exchange and mobile naloxone distribution are a key part of that,” said Kenney Miller, the executive director of the Maine Health Equity Alliance, an organization that runs half the state’s syringe exchanges.

Miller is not a church member, he said, but supports the church’s efforts to provide care in areas his brick-and-mortar facilities simply can’t reach, despite the illegality.

“There’s a difference between legal and right,” Miller said. “They’re answering to a higher understanding of what the right thing to do is.”

Harvey demonstrates to an unidentified person how to administer naloxone in the event they encounter someone overdosing opioids.

Harvey is far more soft-spoken than his brash tactics and cult following among harm-reduction believers might suggest. He has a long and complicated personal history with alcohol and drug use, one that got him briefly thrown out of college when he was younger, kicking off a spiral that led to five involuntarily incarcerations in psychiatric facilities.

The final time, Harvey said, “I was upset for the first week or two I was locked up, but then something clicked in my head. The fog had lifted, and I was curious about this thing I had heard of called recovery.”

Despite his lengthy addiction history, Harvey has injected drugs just three times, he said — experiences that have guided his work as a peer support coordinator three-plus years into his own long-term recovery. All three times, he said, he did so “unsafely,” for lack of access to clean supplies.

Now, in addition to a growing consulting practice in harm reduction and addiction treatment, Harvey works as a peer recovery coach in Portland, guiding individuals with substance use disorders through recovery. He also founded Journey House, an expanding chain of sober living homes in Maine — one of which is the state’s first such facility for women that allows medication-assisted treatment.

Harvey is admired across the harm reduction community — a “rising star,” in Tilley’s words. The approval derives in part from Harvey’s enthusiasm and ability to form coalitions, and in part for having translated his lived experience into ambition for helping others.

Leaning against the red Honda Fit, Harvey remained chatty throughout the night, greeting those who came to pick up naloxone doses and drop off used syringes with a familiarity striking for a weekly gathering that barely dates back two months.

Harvey is modest, shying away from his fellow churchgoers’ latest hobby: turning him into an online meme that makes him out to be a messianic figure, an Uncle Sam-type recruiter drafting a harm-reduction army. As ambitious as the organization has become, he often downplays its current scope.

“There are operations that deliver more syringes to people than we do, deliver more Narcan,” he said, pacing slightly to ward off the cold. “But we’re using syringe exchange as a means to an end — shifted public policy, shifted culture. I’m in the short game and the long game.”

In his business card, Harvey describes himself as a “disciple and acolyte.” He is careful to specify that “he/him/his” are his preferred gender pronouns. There are just three requirements for new church chapters: that they welcome members of all faiths, support all marginalized communities, and espouse evidence-based harm reduction principles.

He often tells church members that they shouldn’t feel shame if they use drugs while pursuing treatment and counseling for addiction. Throughout that frigid Wednesday night, Harvey would repeat the same phrase: “Relapse is a part of recovery.”

He has made that motto part of his many day jobs, all of which are guided by the same principle: “People who use drugs don’t deserve to die.”

Harvey with several unidentified clients on a Wednesday night in December.

A woman in a pink hoodie not nearly warm enough for a night outdoors was looking for a free Wi-Fi network last week when she and her fiance stumbled across Harvey and his Honda.

Harvey called across the street: “Do you want some naloxone?”

The woman replied that the couple had been sober nearly six months. That’s terrific, Harvey said — but perhaps they had friends at risk.

Once the couple agreed to cross the street, however, Harvey’s funding obstacles were put on display. The naloxone he offers is injectable, meaning a user will have to quickly use a hypodermic syringe to draw the liquid from a vial before inserting it into an individual’s upper arm or thigh. Other versions are far easier to use, but far more expensive.

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The fiance — who, like most of those who relied on Harvey’s church for clean supplies, spoke on the condition of anonymity — said he had previously owned a fancier form of naloxone: an Evzio auto-injector. He said the device was stolen in the months before two of the man’s roommates nearly died of overdoses.

Despite the added difficulty, the man said, “If I have to stick someone in the ass to save their life, I’ll do it.”

This is the work being done not just in Lewiston but by five other Maine chapters: Portland, Bangor, Biddeford, Rockland, and a regional chapter serving Western Maine. Chapters in Philadelphia, Western Massachusetts, New Hampshire, and Knoxville, Tenn., are recent additions, as are two small chapters in West Virginia. A still-forming operation in Baltimore would bring the chapter total to 13.

The Bangor chapter is in the triple digits for needles distributed and collected. One member, Marion Anderson, said that every time that chapter has organized an event, she has run out of naloxone doses to distribute.

In Lewiston, Harvey and two other church members found limited foot traffic on the steps of city hall the morning after their Wednesday night event, where they intended to run a naloxone training to protest the city government.

Harvey offered a dose of the lifesaving drug to a man walking by.

“Hell yeah,” the man called back, not stopping but pounding lightly on his heart. “Put it right here.”

Excellent! A comprehensive story, fair and extremely well written. PLEASE kindly email me the link. When I tried the link it said the page was down. Keep such an article up and accessible; your readership will skyrocket, and I will be able to send it. PLEASE. PLEASE email me it. I thank you in advance for both the link and your excellent reporting!! Thank you, Catherine

It is 2 decades out, and still solutions that work are few and far between. There are still too many lies and a lot of denial presented by our mass media. Most churches spread shame, lies, stigma and denial, even after it was not proven to work. Churches took taxpayer money to provide ineffective, and virtually useless 12 Step programs. The media misreported on the effectiveness.
This so called epidemic exposes the lies and lack of science, presented by the industries that are profiting from it. 2 decades out and the media is still lying and misreporting, science and facts are a matter of opinion. These kinds of Harm Reduction Programs are proven to work, but we won’t see this article go viral in mass media. All we can expect is more lies, misinformation and marketing, as more people die.

Lives saved is good. But this article focuses 99% on the logistics of the outreach. Once you save the life physically, where is the discussion of how to save the soul within that body? Without finding a way to LIFE, the cycle is rarely broken.

I don’t blame the pharma companies. Tech is morally neutral. Is we people who cant cope. People take the drugs. People avoid the pain and boredom of our current society. People have to dig till the light comes to them.

But if they are dead, there aint no more digging, except the 6 ft. hole.